Short-term medical: a bridge between plans.

Short-term medical (STM) is temporary coverage that bridges a gap between health plans, like the stretch between leaving a job and starting a new one or building a business until it can support a real plan. It is not ACA-compliant comprehensive major medical coverage. It does not cover pre-existing conditions, it can cap how much it pays out, and it skips benefits the ACA requires such as maternity. In Arizona it is legal and, as of mid-2026, available with durations up to 36 months. It works well for a healthy person filling a known, temporary gap. It works badly for almost everyone else, and we would rather say so before you buy than after you file a claim.

What short-term medical actually is

An STM plan covers you for a defined stretch of time, usually a few months up to a few years, with a deductible and a per-term benefit limit. You answer a short list of yes/no health questions at application, and if you answer no to all of them you are typically approved with coverage starting as soon as the next business day. There is no open enrollment window and no qualifying life event required. You can buy it in June or December, it does not matter.

What you are really buying is protection against a sudden, serious event during a gap: a broken leg, an appendix, a car accident. That is a genuine use. What you are not buying is a plan that treats your diabetes, fills your maintenance prescription, or covers a pregnancy. Those are different products, and confusing the two is where people get hurt.

Where it actually fits

The cleanest example: a 32-year-old who just left a corporate job to start a business. COBRA quotes back at $650 a month for coverage they barely use. They are healthy, they take nothing daily, and they need maybe eight months until the business can carry a real plan. An STM plan in that situation can run roughly $100 to $200 a month for a healthy non-smoker in Arizona depending on the deductible and term you pick. That buys time without bleeding cash. Real quotes vary, so treat that as a range, not a promise.

Other clean fits: waiting out the gap before Medicare starts, the months between graduating and a job's benefits kicking in, or a new hire stuck in a 60 to 90 day benefits waiting period. The common thread is a known end date and a healthy person who mostly needs catastrophic protection, not ongoing care.

The limitations we will not gloss over

STM does not cover pre-existing conditions, and the lookback period (how far back the insurer reviews your history) typically runs two to five years depending on the carrier. If you were diagnosed with Type 2 diabetes two years ago, an STM plan will almost certainly exclude everything related to it. That person needs an ACA plan, because the marketplace cannot turn you down or exclude the condition.

• Benefit caps are real. Some plans cap total payout at levels like $250,000, $500,000, or $1 million per term. A multi-day ICU stay can run at those numbers fast.
• Maternity is not covered. If pregnancy is even a possibility, STM is the wrong product.
• Prescription coverage is limited or absent on most plans. If you take a maintenance medication, price that out separately before you commit.
• Mental health, substance use treatment, and routine preventive care are commonly excluded.

The risk almost no one warns you about

Front-end underwriting on STM is light, just those yes/no questions. The catch comes on the back end. When you file a large claim, the insurer can go back and scrutinize your application, and if they find a condition you did not disclose, or even one that arguably connects to your claim, they can deny it. We have seen it happen, and it is the single biggest way people get burned by these plans.

So answer the health questions carefully and completely. Do not gloss over an old diagnosis because it feels minor or because you have moved on from it. If you are unsure whether something counts, that is exactly the kind of thing to talk through with us before you sign, not after the hospital bill lands.

How it's different from an ACA plan

An ACA marketplace plan cannot reject you, cannot exclude a pre-existing condition, cannot cap your benefits, and covers the full set of essential health benefits including maternity, mental health, and prescriptions. If you qualify for premium tax credits, the subsidy can make a marketplace plan cheaper in real dollars than it looks on the sticker. STM has none of those protections and none of the subsidies.

One thing worth knowing: if you just lost job-based coverage, you usually have a 60-day special enrollment window to pick up an ACA plan. Buying STM during that window without at least checking the marketplace option can mean walking past a subsidy you were entitled to. We look at both before recommending either.

How Apex shops it for you

We are an independent agency, so we are not tied to one carrier's product. Brent, our lead health agent, typically works with carriers like Everest, Pivot Health, and National General for Arizona STM, and we match the plan to your specific gap length and health profile rather than selling whatever pays best. The agency is free to you; carriers pay the commission either way, so our incentive is to get the fit right and keep you as a client.

A note on the rules: Arizona currently allows STM with durations up to 36 months. The federal picture has been in flux. The 4-month cap from 2024 stopped being enforced in 2025, so longer 12-month and 36-month plans are back on the market for Arizona buyers right now. We track this so you do not have to. Call us at 623-292-4360 and we will tell you honestly whether STM is your tool or whether you should be on the marketplace instead.

Short-term medical (STM) is NOT ACA-compliant comprehensive major medical coverage. It does not cover pre-existing conditions, may exclude essential health benefits such as maternity, mental health, and prescription drugs, and can impose annual or lifetime benefit caps. Apex Health Advisors does not guarantee coverage or pricing; all plans are subject to carrier underwriting and approval. Premium ranges shown are general estimates, not quotes.